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Voyeurism -ˌiz-əm

(Voyeuristic Disorder)

By George R. Brown, MD, Chief of Psychiatry;Professor and Associate Chairman, Department of Psychiatry, Mountain home VAMC, Johnson City, TN;East Tennessee State University

Voyeurism involves becoming sexually aroused by watching an unsuspecting person who is disrobing, naked, or engaged in sexual activity. Voyeuristic disorder involves acting on voyeuristic urges or fantasies or being distressed by or unable to function because of those urges and fantasies.

  • Most voyeurs do not have voyeuristic disorder.

  • Doctors diagnose voyeuristic disorder when people feel greatly distressed or become less able to function well because of their behavior, or they have acted on their urges with a person who has not consented.

  • Treatment, which usually begins after voyeurs are arrested, includes psychotherapy, support groups, and certain antidepressants.

Voyeurism is form of paraphilia. Most people with voyeuristic tendencies do not have voyeuristic disorder.

In voyeurism, it is the act of observing (peeping) that is arousing, not sexual activity with the observed person. Voyeurs do not seek sexual contact with the people being observed. When voyeurs observe unsuspecting people, they may have problems with the law.

Voyeurism usually begins during adolescence or early adulthood. Some degree of voyeurism is common, more among boys and men but increasingly among women. Society often regards mild forms of this behavior as normal when involving consenting adults. Viewing sexually explicit pictures and shows, now widely available in private on the Internet, is not considered voyeurism because it lacks the element of secret observation, which is the hallmark of voyeurism.

Voyeuristic disorder is one of the most common paraphilias and is much more common among men.

When voyeurism is a disorder, voyeurs spend a lot of time seeking out viewing opportunities. As a result, they may neglect important aspects of their life and not fulfill their responsibilities. Voyeurism may become the preferred method of sexual activity and consume countless hours of watching.

Diagnosis

  • A doctor's evaluation, based on specific criteria

Doctors diagnose voyeuristic disorder when

  • People have been repeatedly and intensely aroused by observing an unsuspecting person who is naked, undressing, or engaging in sexual activity, and the arousal has been expressed in fantasies, urges, or behaviors.

  • As a result, people feel greatly distressed or become less able to function well (at work, in their family, or in interactions with friends), or they have acted on their urges with a person who has not consented.

  • They have had the condition for 6 months or more.

Treatment

  • Psychotherapy, support groups, and certain antidepressants

  • Sometimes other drugs

Treatment usually begins when voyeurs are arrested. It includes psychotherapy, support groups, and antidepressants called selective serotonin reuptake inhibitors (SSRIs).

If these drugs are ineffective and the disorder is severe, drugs that reduce testosteronelevels and thus reduce the sex drive may be used. These drugs include leuprolide and medroxyprogesterone acetate. People must give their informed consent to the use of these drugs, and doctors periodically do blood tests to monitor the drug’s effects on liver function, as well as other tests (including bone density tests and blood tests to measure testosteronelevels).

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • LUPRON
  • DELATESTRYL
  • PROVERA